Rethinking the Unthinkable
VIDEO (coming soon)
Quick thinking, cooperation, preparedness and adaptability are all key to working safely and effectively when disaster hits.
Rafael E. Campo, a physician and professor at UM’s Miller School of Medicine, pointed to all of these qualities as he described the rush to improvise in post-earthquake Haiti last year during the “Disaster Preparedness: Pandemics, Natural and Man-Made Disasters” panel at the University of Miami Global Business Forum, held Jan. 12–14, 2011.
During the five months following the quake, UM doctors and volunteers from around the country treated 30,000 patients and performed 1,500 surgeries. The university set up a 250-bed tent hospital while dealing with complex logistics; it also coordinated travel and housing for the volunteers, routed thousands of donated goods and even negotiated a sketchy legal position. UM wasn’t licensed to operate a hospital in Haiti, but with the country’s government in shambles, there was no one to apply to for licensing, so organizers got a letter of approval from President Rene Preval. Medicine and supplies were hard to come by, and surgeries were done by flashlight during the first few critical days. Even keeping the equipment they had up and running was a struggle.
Panelists (L-R) Sally Phillips, Deputy Director,
“We had some radiographic equipment that kept breaking down because it was physicians who were running it and we don’t know how to do that,” Campo said, adding that the manufacturer eventually sent a representative to Haiti to run the equipment.
He also described one case that highlighted the kind of cross-border cooperation that was key to saving many lives. A child arrived at the hospital with a severe jaw fracture. He needed a maxillofacial surgeon to reconstruct his jaw, but the UM team didn’t have anyone able to perform the surgery. They heard that a Cuban doctor at another hospital had the expertise, and a U.S. army helicopter was dispatched to get her.
“The proper equipment wasn’t there,” Campo said, explaining that surgeons in the U.S. typically use titanium plates to repair such severe fractures. “Being from Cuba, she wasn’t used to working with this stuff anyway. She was used to working with wire.” The surgery was a success and the little boy was saved.
Col. Doug Lougee, a physician with the U.S. Southern Command, described a very different rescue effort in Chile after a much stronger earthquake there. Chile asked the U.S. for help transporting supplies and later for help setting up a field hospital.
“What the Chileans said was ‘We don’t need your medical professionals. We need your hospital,’” Lougee recalled. He noted that the U.S. military can be extremely helpful after a natural disaster, but not everyone wants soldiers running around.
“We’re self-supporting. We take care of our own. We don’t ask for food or water or security. We take what we need,” Lougee said. But “we’re not neutral. OK, the 82nd Airborne landed. There are guys with … guns running around. Some people may view that as a negative.”
And not every disaster requires the same kind of thinking, or action. William Blumentals, global head of epidemiology for virology and transplant at Hoffman-LaRoche, described a study about the effectiveness and safety of the Tamiflu treatment for the H1N1 virus. It turned out that early concerns about Tamiflu were overblown, he said, and the pandemic itself was much less severe than many initially feared. But the next flu pandemic could come at any time.
“Maybe the other take-home message is, it’s good to wash your hands,” he said.
That uncertainty is where preparedness comes into play. Sally Phillips, deputy director of the Health Resilience Division at the Office of Health Affairs, under the U.S. Department of Homeland Security, stressed that no matter the disaster (or pandemic), everyone — including businesses — should have a plan. Businesses, just like governments and volunteer groups, she said, need to be aware of their “surge capacity” — that is, how much they can effectively ramp up operations to deal with a disaster without putting people at risk. Little things like the availability of toilet paper can become big issues if no one plans for them.
“If only 20 percent of your workforce shows up and the CEO is dead or down and the vice president is dead or down, are there redundancies for recovery?” Phillips asked. “What is your plan for sustaining your company if you have a period of time when there is no business?”
By Susannah Nesmith